低剂量前瞻性心电触发序列扫描在房颤患者冠状动脉CT成像的研究  

The feasibility study of low dose prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation

作　　者：徐磊[1] 杨琳[1] 张兆琪[1] 范占明[1] 吕飙[1] 于薇[1] 

机构地区：[1]首都医科大学附属北京安贞医院医学影像科,北京100029

出　　处：《医学影像学杂志》2014年第3期377-381,共5页Journal of Medical Imaging

基　　金：北京市优秀人才项目(2011D003034000030);北京市卫生系统高层次卫生技术人才资助项目

摘　　要：目的研究前瞻性心电触发序列扫描在房颤患者冠状动脉CT成像的可行性。方法前瞻性连续入组94例持续房颤患者,47例患者采用前瞻性心电门控序列扫描,另外47例采用回顾性心电门控螺旋扫描。设备采用第二代双源CT。以冠状动脉段为基础评价图像质量,比较两组的图像质量和辐射剂量。结果前瞻组可诊断的血管段为99.5%(604/607),回顾组为97.7%(570/584),前瞻组显著高于回顾组(P<0.001)。以患者为基础,前瞻组43例(92%)为可诊断,回顾组29例(62%)为可诊断病例。有效辐射剂量在前瞻和回顾组分别为(4.15±1.78)mSv和(12.15±5.38)mSv,两组之间差异有显著性(P<0.001)。序列扫描降低辐射剂量66%。结论采用第二代双源CT,前瞻性心电触发序列扫描对于房颤患者冠状动脉CT成像具有可行性,该扫描方案可以显著降低辐射剂量,并保证诊断所需图像质量。Objective To study the feasibility of prospectively ECG-triggered sequential dual source coronary CT angiog raphy （CCTA） in patients with atrial fibrillation （AF）.Methods 94 consecutive patients with persistent AF were randomly assigned to prospective CCTA and retrospective CCTA.Image quality was evaluated using a four point grading scale on a per-segment and per-patient basis.The image quality and radiation dose between the two groups were compared.Results Diagnostic segment rate in the prospective group was 99.5 ％ （604/607 segments）,while,that in the retrospective group was 97.7％ （570/584 segments） （P =0.006）.On per-patient analysis,92％ was diagnostic in prospective group,while 62％ was diagnostic in retrospective group.Effective dose was 4.15±1.78 and 12.15±5.38 mSv for each of the two groups respectively （P ＜0.001）.There was 66％ reduction in prospective group.Conclusion Prospectively ECG-triggered sequential CCTA is feasible in AF patients.This scan mode can decrease radiation exposure significantly,while maintaining diagnostic image quality.

关 键 词：体层摄影术 X线计算机 冠状动脉 辐射剂量 心率失常 

分 类 号：R814.42[医药卫生—影像医学与核医学] R541.4[医药卫生—放射医学]